Pain in postsurgical orthopedic rehabilitation: a multicenter study

Objective. The aim of this study was to quantify andcharacterize pain in patients undergoing lower limbpostsurgical orthopedic rehabilitation and to inves-tigate the impact of pain in slowing or interruptingtheir rehabilitation.Design. The study was designed as a multicentercross-sectional study.Setting. The study was set in rehabilitation depart-ments of the Don Gnocchi Foundation.Subjects. The study subjects were the inpatientsattending rehabilitation.Interventions. There were no interventions used inthe study.Outcome Measures. Pain intensity was measuredwith a numeric rating scale (NRS); pain characteris-tics were assessed with the McGill Pain Question-naire and the ID Pain (able to discriminatenociceptive from neuropathic pain). Quality of life(QoL) was measured with the Short Form 36 HealthStatus Survey. A semi-structured questionnaire onpain occurrence, impact, and management wasadministered by the physiotherapist in charge of thepatients and by the physician.Results. We studied 139 patients, 82% of whomcomplained of at least moderate pain (NRS3).According to ID pain, 45.6% patients complained ofprobable (33.8%) or highly probable (11.8%) neuro-pathic pain. A higher pain intensity was significantlyrelated to the probability of having neuropathic pain(P<0.001). Patients with more severe pain reportedlower physical and mental QoL scores. In 38.6%of cases, pain interfered with the rehabilitationprocess, and in 18.5% it was the cause of physicaltherapy discontinuation.Conclusions. In light of the high occurrence andintensity of pain in the sample, and of the significantimpact on the rehabilitation program, cliniciansshould pay more attention to pain, especially neu-ropathic pain, in postsurgical patients. Tailored painpharmacological therapy could possibly improvebs_bs_bannerPain Medicine 2012; 13: 769–776Wiley Periodicals, Inc.769 by guest on November 24, 2016http://painmedicine.oxfordjournals.org/Downloaded from patient compliance during the rehabilitation processand enhance long-term outcomes.